‘You’re The Worst,’ ‘Crazy Ex-Girlfriend,’ ‘Lady Dynamite’ Lead the Charge of Mental Health Inclusiveness on TV

More than a decade and a half ago, in 2002, Tony Shalhoub portrayed a police consultant with obsessive-compulsive disorder (OCD) on USA’s procedural “Monk.” Given the show’s comedy roots, his compulsions were often exaggerated, wide-ranging and played as “quirks” that hindered him professionally and personally. But times have changed, and “Monk” was just a starting point.

“We have a vast sea of things that are going on inside of us at all times, especially when we’re in relationships,” says “You’re the Worst” creator Stephen Falk, whose series features characters diagnosed with clinical depression and PTSD. “We’re really just dimensionalizing. We do [this] in order to increase visibility, but also to enrich the fabric of our show.”

Shows such as Fox’s musical drama “Empire” and Showtime’s dysfunctional family comedies “Shameless” and “SMILF” include characters who have been diagnosed as bipolar but are part of larger ensemble casts, whereas Netflix’s comedy “Lady Dynamite” tells its story from its bipolar leading lady’s point of view.

“I feel like whatever your experience, that’s your gift as a comedian or an artist,” says Maria Bamford, who stars in the semi-autobiographical “Lady Dynamite.” “The more specific a point of view, the more marketable” the show often is.

The first season of “Lady Dynamite” saw Bamford’s character experiencing different symptoms, but the second season, which she says reflects the past few years of her own life, explores a healthier point. After all, in order to truly capture what it is like for a person living with such a diagnosis, all parts of the journey must be depicted.

“The driving force of the first season is gone, and I don’t, of course, want that to happen again, even though it’s a very compelling storyline,” Bamford says, adding that the show adjusted its shooting schedule because she didn’t want “to get sick doing a show about getting sick.”

“When you’re no longer the underdog, it can be slightly less exciting, but the writers did a beautiful job writing in the future scenes [to portray] my worst fear and still keep that feeling of being out of control,” she says.

Having a character with mental illness as the focal point of the story often allows the writers to play with the idea of an unreliable narrator. During the second season of “Lady Dynamite,” Maria gets overly excited by a woman with a dog, which makes her boyfriend wonder if she’s in the middle of another manic episode.

USA’s “Mr. Robot,” in which the titular character is actually a fragment of hacker Elliot’s (Rami Malek) own identity, dives even deeper into that storytelling technique. Although Elliot has dissociative identity disorder (DID), the truth about Mr. Robot was not revealed until the end of the first season, when the show stepped outside Elliot’s POV.

“I wanted the show to feel like a subjective experience. When you’re dealing with unreliable narration like that, the audience might feel a little untethered with the world, but that’s the experience you want them to feel,” says “Mr. Robot” creator Sam Esmail, who has struggled with social anxiety disorder himself. “You feel like you’re fighting your way through the dark, and there’s a lot of trial and error. There are no clear cut answers or easy solutions to fix something as entrenching as Elliot’s disorder. We don’t play it for plot machinations or tropes. We try to explore the desperation that comes with it.”

“We don’t play it for plot machinations or tropes. We try to explore the desperation that comes with it.”
Sam Esmail

As “Mr. Robot” has continued into its third season, Elliot’s issues have deepened, at times because he has tried self-medicating. Elliot’s drug of choice has been heroin, whereas Luisa (Yara Martinez) on the CW’s “Jane the Virgin” turned to alcohol to cope after she had a breakdown and experienced hallucinations of her own.

These elements add extra layers to already intricate storytelling because, as “Jane the Virgin” showrunner Jennie Snyder Urman puts it, self-medicating can often “mask the illness” for those who experience it, as well as those around that person.

On “Shameless,” Ian Gallagher’s (Cameron Monaghan) diagnosis of bipolar disorder didn’t come until the fourth season finale. Instead, much of that season had his on-screen family and the audience alike wondering if he was just on drugs, as his emerging manic behavior mimicked cocaine use.

“You’re the Worst’s” Falk admits that sometimes there can be a “Trojan horse nature” to television, wherein a show sells itself one way initially, but then over time introduces additional facets after easing the audience into the more complex issues and storylines.

Though Falk knew from the onset that he wanted to tackle PTSD on-screen due to his interest in veterans’ rights, he says Gretchen’s (Aya Cash) history with clinical depression didn’t come up in his writers’ room until they were breaking the second season and exploring the “why” behind her already established pattern of behavior. The show revealed that aspect of her backstory that year and then in season three dove even deeper into both her depression and Edgar’s (Desmin Borges) PTSD.

Similarly, the CW’s “Crazy Ex-Girlfriend” introduced Rachel Bloom’s Rebecca Bunch as a character who identified as living with anxiety and depression. But the third season of the musical comedy saw Rebecca re-diagnosed and start to be treated for borderline personality disorder (BPD).

“A huge part of her struggle was that she knew she was unhappy and she knew things were a struggle for her, but she didn’t know why,” says “Crazy Ex” executive producer Aline Brosh McKenna. “We read that it takes five to eight years to get a diagnosis of borderline; they’re almost always diagnosed with a bunch of other things first.”

McKenna doesn’t consider “Crazy Ex” to be breaking completely new ground by depicting a character with BPD: she believes characters have exhibited the behaviors of the disorders in a number of prior shows; they just hadn’t been explicitly labeled. However, McKenna thinks there is more openness about exploring diagnoses on television now because of the hunger for different voices and journeys.

“Things have taken a turn towards being more driven by what storytellers want to tell, and there’s less of the pressure to conform to things that are safe or to make everybody likeable all of the time,” she says.

Characters living with mental illnesses are still not that widespread on television, so writers are taking great care to avoid anything that might seem like tokenism or to try and have these characters represent all people with that illness.

“It’s impossible to try to represent everyone. If you try to represent everyone in any story, you’re going to represent no one,” Falk says. “My mantra has always been ‘as specific as I can make it, they will feel more universal because they will feel more real.’ So, as long as it’s ringing true for some or a majority or a lot or even one, I think that’s the more important job.”

Additional responsibility may come with depicting these characters as they struggle with their decisions about which treatments to try, and often see setbacks. But the visibility of well-rounded characters who accept the label of a diagnosis but don’t allow themselves to be defined by that diagnosis goes a long way towards destigmatization.

“It was really important for us to really own the diagnosis because there’s no shame in having an illness, but with mental illness it’s sometimes still hard for people to see it that way,” McKenna says. “It takes a lot of courage for someone to try to get better, and it’s important for the show to be kind as kind and compassionate about [the character] and her disorder as possible.”