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It’s been a quiet day at the reference desk at the rural public library where I work, but the hum begins to pick up as the afternoon wears on. Teens drift in, looking for books, movies, and video games. One of my regulars approaches me. He comes up to the desk once a month or so, and always for the same reason.
“Do you have any books on anxiety?” he asks.
I decide to skip the reference interview with him. The last time, it seemed to mute him and he ran.
“Sure let me show you,” I say, quickly heading toward the 600s. “Do you think any of these will be helpful?” There’s John Giacobello’s Everything You Need to Know About Anxiety and Panic Attacks, Lisa M. Schab’s The Anxiety Workbook for Teens, and Freaking Out: Real Life Stories of Anxiety, edited by Polly Wells.
“No,” he says, picking at the binding of the book nearest him.
“Can you give me any more details on what you might want?”
“Definitely not what I’m looking for,” he mutters as he disappears.
The next time he comes in, something is different. He makes eye contact. “Do you have any books on anxiety…Not information, but stories about anxiety? A novel?” he asks.
So he doesn’t want clinical information. He wants stories.
I go to the catalog, hoping to find one before I lose him. My search of the Novelist database, including the terms “realistic teen fiction” and “anxiety,” pulls up too many hits—and none seem quite right. The first has to do with superheroes. The next is about the “anxiety” of being in the popular group.
My friend starts turning away.
“Let’s have a look over here,” I say, heading to the teen space. I recently ordered a book with anxiety as a theme, and I know that the cover is blue. I scan the shelves. Blue, blue, blue. There it is—Dr. Bird’s Advice for Sad Poets by Evan Roskos. I’ve read it and know the context. I flip to the first page and point to the line: “I am a depressed, anxious kid.”
My friend takes it, then nods, turns, and slips away. For the moment, I feel triumphant.
The statistics on mental illness
This and other experiences I’ve had make me start thinking about teens, mental illness, and the potential of bibliotherapy. According to the National Institute of Mental Health (NIMH; 2012 data), approximately 2.2 million, or 9.1 percent, of U.S. adolescents ages 12 to 17 had at least one major depressive episode in the past year. Millions more endure other conditions.
While mental illness is clearly prevalent, a stigma persists. A recent article in Time, prompted by the suicide of actor Robin Williams, estimated that about 60 percent of those suffering from mental illness don’t seek assistance. Reading is not a replacement for professional therapy. But surely, the right books can help.
The next week, I have a teen shadowing me for an economics class assignment. She tells me that she might ask a lot of questions, that her mind works differently, and that she has Asperger’s syndrome.
She also tells me that someday she will write a book about having Asperger’s—but not now, because she isn’t allowed to shout “loud and proud” about her condition. Her parents warned her not to tell her peers.
This may be for her own protection. Kids with mental illness—kids with pills—can be confronted by others trying to buy or steal them. They can also be targets of ridicule.
She admits that her situation can be frustrating, isolating—like a dirty secret. I ask if she has read Rogue by Lyn Miller-Lachmann and notice that she checks it out before leaving the library.
Several days later, teens gather for our library’s weekly movie making club. One girl travels from three towns over to be there. I don’t know her very well, but I do know that she is in foster care. Sometimes she shows up with her therapist. Often, she seems to be in need of attention one moment and eager to be alone the next—turning away would-be friends with a cutting comment.
She settles in with the other kids who are sketching out ideas on neon card stock and talking. I overhear one make a joke about rape. “Hey, lay off it,” the girl says. “Some of us have to live with bad memories.” The group falls silent.
I want to help her, and consider retrieving the Department of Health and Human Services info book, or finding the number for a local mental health organization. But she has a therapist already. Furthermore, she isn’t asking me for that information. A book might provide some comfort, though I know I don’t have the context or the rapport to confidently hand her the right one. Perhaps Laurie Halse Anderson’s Speak, or Stephanie Kuehn’s Charm & Strange.
If the books are out in the open, maybe she would stumble upon a useful title on her own. I decide to create a display, starting off with a list of the 16 disorders under the term “Mental Illness” provided by the National Alliance of Mental Illness website. The conditions currently listed range from anxiety and autism spectrum disorders to eating disorders and schizophrenia. Then I dig for teen novels related to these conditions. Many of my favorite authors are among them: Matthew Quick, Ellen Hopkins, Benjamin Alire Sáenz.
The next afternoon, all but two of the eight titles are gone. Were they taken by teens looking for themselves in the pages—or others seeking to recognize peers, friends, or family members? Did Laurie Halse Anderson’s Wintergirls end up with someone struggling with anorexia? Did Hilary T. Smith’s Wild Awake find its way into the hands of someone feeling manic? Is Matthew Quick’s Forgive Me, Leonard Peacock being read by someone who had been abused?
The promise of bibliotherapy
The statistics about teens and mental illness are staggering. In addition to the 2.2 million who experienced depression within the past 12 months, according to the NIMH data, 25.1 percent of youth from ages 12 to 17 experienced some sort of anxiety within the same time period, whether it was generalized, obsessive-compulsive disorder (OCD), agoraphobia, or something else. Nine percent had attention deficit disorder, and two percent had an eating disorder. The list goes on.
Can reading help significantly? To my mind, as both a librarian and a writer, the answer is a resounding yes. Fiction has a special magic to it—the ability to weave a world outside reality. To simulate experiences and outcomes. For someone who feels alone, a friend awaits within the pages—someone who says, “Yes, I’ve been there. Have gone through that. Am suffering along with you.”
Is my perspective on the power of bibliotherapy accurate? To find out, I went searching, talked to some people, and discovered promising research on the topic.
“We use books with parents and kids to promote the feeling that their problems are not isolated problems,” says Lisa Estivill, the director of Adolescent Therapeutic Education and After School Services at Washington County (VT) Mental Health Services. “Many of our kids have read books in class and with their clinicians to help them better contextualize their disabilities and/or validate their experience.”
While professionals agree that bibliotherapy isn’t a mainstream methodology or a replacement for professional therapy, it can be a beneficial part of the therapeutic process.
“Bibliotherapy can serve as an unobtrusive, non-threatening medium to help adolescents relieve their stress and increase their coping skills,” write Heidi L. Tussing and Deborah P. Valentine in their 2001 article “Helping Adolescents Cope with the Mental Illness of a Parent through Bibliotherapy,” published in Child and Adolescent Social Work Journal. Tussing and Valentine write: “They (readers) gain insight, on the problem-solving and coping skills of the characters, subsequently applying this learning to their own lives.”
Books offering insights into a peer’s condition are also beneficial, says David Rice, children, youth, and family services education coordinator at the Ch.O.I.C.E (Changing Our Ideas Concerning Education) Academy, an integrated transitional mental health facility and education center in Vermont. Rice cites an experience he had when his students read Anything But Typical by Nora Raleigh Baskin, a novel about a character who has Asperger’s syndrome. “Only one of the boys in class had Asperger’s, but the most profound aspect of the experience was what the other students learned about how his mind works, and how he corroborated with his peers what the character was feeling,” Rice says.
In Rice’s opinion, such experiences of bibliotherapy have far-reaching impact. “Though I have no concrete evidence of the effectiveness of bibliotherapy, through student responses and reactions, I would say it is not only helpful, but could also be profound,” he says.
Finding the right story
“Mental illness” is a vast term, and yet titles of all kinds are often placed in this catch-all category, which creates a challenge in retrieving the right book for a patron. Reading a book about a protagonist with an eating disorder is very different than reading one about someone with schizophrenia. Additionally, writers often steer clear of diagnostic terms.
On the one hand, I understand that not everyone fits into a label. As a creative writer, I hate labels. But as a librarian, I want to find the right book. A label, a category, would help.
Inspired by my book display, I set about creating a book list of realistic teen fiction with representation of mental illness organized by disorder. I have verified the category placement by MARC records, jacket copies, or, when those were unclear, confirmation by the authors themselves.
While I’m not claiming that books can be a substitute for therapy, within the right context, I believe they can serve as valuable touchstones, conversation starters, and companions. It is my hope that this list can help librarians, teachers, therapists, and teens better identify books to suit their specific needs. So that everyone might find a Dr. Bird—a companion on an often too solitary road.
Erin E. Moulton is a teen librarian at the Derry (NH) Public Library and author of Chasing the Milky Way (Penguin Random House, 2014).
Realistic Teen Fiction and Mental Health
A Book List
Caletti, Deb. The Nature of Jade (S. & S., 2007)
Baskin, Nora Raleigh. Anything but Typical (S. & S., 2009)
Colasanti, Susane. Waiting for You (Viking, 2009)
Herbach, Geoff. Stupid Fast (Sourcebooks Fire, 2011)
*Roskos, Evan. Dr. Bird’s Advice for Sad Poets (Houghton Harcourt, 2013)
Schutz, Samantha. I Don’t Want to Be Crazy (Scholastic, 2006)
Autism spectrum disorders
Choldenko, Gennifer. Al Capone Does My Shirts (Putnam, 2004)
Erskine, Kathryn. Mockingbird (Philomel, 2010)
Franklin, Emily, and Halpin, Brendan. The Half-Life of Planets (Hyperion, 2010)
Haddon, Mark. The Curious Incident of the Dog in the Night-Time (Doubleday, 2003)
Jacobs, Evan. Screaming Quietly (Saddleback, 2013)
Kelly, Tara. Harmonic Feedback. (Holt, 2010)
Lyn Miller-Lachmann. Rogue (Nancy Paulsen, 2013)
Miller, Ashley Edward. Colin Fischer (Penguin, 2012)
Roy, Jennifer. Mindblind (Marshall Cavendish, 2010)
Stork, Francisco X. Marcelo in the Real World (Scholastic, 2009)
Attention deficit disorder (ADD)/Attention deficit hyperactivity disorder (ADHD)
Costa, T.L. Playing Tyler (Strange Chemistry, 2013)
Page, Katherine Hall. Club Meds (Simon Pulse, 2006)
Rue, Nancy. Motorcycles, Sushi and One Strange Book (Zonderkidz, 2010)
Hopkins, Ellen. Impulse (Simon Pulse, 2007)
Niven, Jennifer. All the Bright Places (Knopf, 2015)
Reed, Amy. Crazy (Simon Pulse, 2012)
Polsky, Sara. This Is How I Find Her (Albert Whitman, 2013)
Sones, Sonya. Stop Pretending: What Happened When My Big Sister Went Crazy (HarperCollins, 1999)
Smith, Hilary T. Wild Awake (HarperCollins, 2013)
Wilson, Jacqueline. The Illustrated Mum (Delacorte, 2005)
Wunder, Wendy. Museum of Intangible Things (Penguin, 2014)
Asher, Jay. Thirteen Reasons Why (Penguin, 2007)
Cardi, Annie. The Chance You Won’t Return (Candlewick, 2014)
Draper, Sharon M. “Hazlewood High Trilogy” (S. & S.)
Ford, Michael Thomas. Suicide Notes (Harpercollins, 2008)
Green, John, and Levithan, David. Will Grayson, Will Grayson (Dutton, 2010)
Halpern, Julie. Get Well Soon (Feiwel and Friends, 2007)
Hubbard, Jennifer R. Try Not to Breathe (Viking, 2012)
Jenkins, A.M. Damage (HarperCollins, 2001)
Jones, Traci L. Silhouetted by the Blue (FSG, 2011)
McNamara, Amy. Lovely, Dark and Deep (S. & S., 2012)
*Quick, Matthew. Sorta Like a Rock Star (Little, Brown, 2010)
Sales, Leila. This Song Will Save Your Life (FSG, 2013)
Schumacher, Julie. Black Box (Delacorte, 2008)
Vizzini, Ned. It’s Kind of a Funny Story (Hyperion, 2007)
Wolitzer, Meg. Belzhar (Dutton, 2014)
*also PTSD and autism
Cusick, John M. Girl Parts (Candlewick, 2010)
*Hopkins, Ellen. Identical (S. & S., 2008)
Leno, Katrina. The Half Life of Molly Pierce (HarperCollins, 2014)
*also eating disorders
Dual diagnosis: mental illness and substance abuse
Sáenz, Benjamin Alire. Last Night I Sang to the Monster (Cinco Puntos, 2009)
*PTSD and alcoholism
Anderson, Laurie Halse. Wintergirls (Viking, 2009)
Anonymous. Letting Ana Go (Simon Pulse, 2013)
Bell, Julia. Massive (Young Picador, 2003)
Colbert, Brandy. Pointe (Putnam, 2014)
Friedman, Robin. Nothing (Flux, 2008)
Hopkins, Ellen. Perfect (S. & S., 2011)
Jaden, Denise. Never Enough (Simon Pulse, 2012)
Kaslik, Ibi. Skinny (Walker, 2006)
Littman, Sarah Darer. Purge (Scholastic, 2009)
Metzger, Lois. A Trick of the Light (HarperCollins, 2013)
Reed, Amy. Clean (Simon Pulse, 2011)
Shahan, Sherry. Skin and Bones (Albert Whitman, 2014)
Vrettos, Adrienne Maria. Skin (S. & S., 2006)
Obsessive-compulsive disorder (OCD)
Ayarbe, Heidi. Compulsion (HarperCollins, 2011)
Chappell, Crissa-Jean. Total Constant Order (HarperCollins, 2007)
Harrar, George. Not as Crazy as I Seem (Houghton Mifflin, 2003)
Haydu, Corey Ann. OCD Love Story (Simon Pulse, 2013)
Hopkins, Ellen. Fallout (S. & S., 2010)
Karo, Aaron. Lexapros and Cons (FSG, 2012)
McGovern, Cammie. Say What You Will (HarperCollins, 2014)
Vaughn, Lauren Roedy. OCD, the Dude, and Me (Dial, 2013)
Wilson, Rachel. Don’t Touch (HarperCollins, 2014)
Posttraumatic stress disorder (PTSD)
War and Death
Anderson, Laurie Halse. The Impossible Knife of Memory (Viking, 2014)
Avashti, Swati. Chasing Shadows (Knopf, 2013)
Doller, Trish. Something Like Normal (Bloomsbury, 2012)
Herbach, Geoff. “Reinstein Trilogy” (Sourcebooks Fire)
Morgenroth, Kate. Echo (S. & S., 2007)
Quick, Matthew. Boy21 (Little, Brown, 2012)
Reinhardt, Dana. The Things a Brother Knows (Random/Wendy Lamb, 2010)
*King, A.S. Reality Boy (Little, Brown, 2013)
Kuehn, Stephanie. Charm & Strange (St. Martin’s Griffin, 2013)
**Kuehn, Stephanie. Complicit (St. Martin’s Griffin, 2014)
*Mesrobian, Carrie. Sex and Violence (Carolrhoda, 2013)
**Quick, Matthew. Forgive Me, Leonard Peacock (Little, Brown, 2013)
Perry, Jolene. Stronger Than You Know (Albert Whitman, 2014)
***Rainfield, Cheryl. Scars (WestSide, 2010)
Rainfield, Cheryl. Stained (Houghton Harcourt, 2013)
Averett, Edward. Cameron and the Girls (Clarion, 2013)
Bock, Caroline. Before My Eyes (St. Martin’s Griffin, 2014)
*de la Peña, Matt. I Will Save You (Delacorte, 2010)
James, Brian. Life Is But a Dream (Feiwel and Friends, 2012)
Schindler, Holly. A Blue So Dark (Flux, 2010)
Sheff, Nic. Schizo (Philomel, 2014)
Suma, Nova Ren. 17 & Gone (Dutton, 2013)
Trueman, Terry. Inside Out (HarperCollins, 2003)
Ayarbe, Heidi. Compromised (HarperCollins/HarperTeen, 2010)
Friesen, Jonathan. Jerk, California (Speak, 2008)
Note: I was unable to identify realistic teen fiction titles for borderline personality disorder, panic disorder, seasonal affective disorder, and schizoaffective disorder. Feel free to suggest titles in the comments section.