A Psychologist Explains How 13 Reasons Why Isn’t Really About Mental Health
Surrounded by hype and controversy, 13 Reasons Why has become a wildly popular Netflix series with a highly anticipated Season 2 already in the works. The emotionally draining show (which centers on one teen’s suicide) has brought major issues like bullying, assault, and rape into everyday conversations — and, though heartbreaking, one psychologist says the show isn’t all about mental health. Dr. Lauren Hazzouri, the licensed psychologist behind Hey Lauren, broke down how she sees the storyline and exactly how it can affect girls and women who are struggling. She also gave us some super-helpful tips for maintaining mental wellness.
B+C: Did you watch 13 Reasons Why? What was the experience like for you, a psychologist?
LH: I watched the entire first season of 13 Reasons Why. The episodes were hard to get through, especially for me — I binge-watched the series to become familiar with what the girls in my office and in the #HeyLauren Community were talking about. After watching it, I didn’t feel right for several days. It was SO triggering for me, despite years of personal and professional experience.
As I shared in a recent newsletter, I don’t believe the show is about mental health; it’s about misogyny. To be totally honest, my visceral response is evidence that no matter who we are, where we’re coming from, all of us (girls and women) are significantly affected by social norms and the way we’re seen (or not seen) and treated daily. The part I think mental health professionals, school administrators, parents, and the producers of the series have missed is that we, girls and women, are ALL victims to some degree of sexism, misogyny, toxic masculinity, slut-shaming, and cumulative micro-aggressions. Our feelings and reactions to our experiences are not to be labeled but understood.
B+C: The show is definitely emotional and brings a ton of important topics to light. You mention your patients and community as motivation to watch the show; have you noticed any conversation trends following the release of 13 Reasons Why? Can you pinpoint that they’re tied to the show?
LH: In weeks following the launch, I’ve seen an increase in panicky phone calls from moms of teens, hoping to get their daughters into the office for an intake following reports of suicidal thoughts or following a 72-hour stint in the hospital after being admitted for suicidal ideation and intent. Interestingly, girls who had already been in therapy, girls who were already able to see themselves separate from society, girls who could identify the problem didn’t have the same reaction to the series. While many of them found it disturbing and stated, “The show was about me!” they had the ability to respond vs. react in a way that girls without those insights weren’t able to.
My concern is that the response to 13 Reasons Why reinforces the very reason that the show strikes such a chord with girls: Simply warning girls NOT to watch what they experience every day, pretending that if they don’t see it play out on their computer screens that they’ll be safe, has the potential to leave our girls feeling alone and hopeless. Girls who identify with Hannah Baker are really watching our reactions, listening for our responses, and looking for hope. The truth IS the hope.
B+C: Wow, we’re speechless. As a psychologist, how do you approach these situations? What do you think girls and women need to know, specifically?
LH: I want all girls and women to know that YOU are not the problem. Your pain and symptoms have become part of your identity, but they’re not you. I’ve noticed that many people internalize a diagnosis (this even counts self-diagnoses of “crazy” or “messed up”), and think that depression, anxiety, or bipolar disorder is a trait like height or extroversion — this couldn’t be further from the truth.
If this resonates with you, please know that I’m not just saying so to help you feel better about yourself; I’m stating facts. And hey! It’s totally understandable if you’ve fallen into this trap — I too have been there and done that. Societal messaging with regards to women and mental health dates back centuries, so your ability to see the difference between you and your symptoms is not only NOT taught, but much of what you’re experiencing as symptoms is secondary to what you have been taught. Seeing yourself clearly and not internalizing all of this stuff is not only necessary for you as an individual, but it’s critical for each of us to do for all of us.
B+C: Beautifully said — what an important message to deliver. As you see it, what does a legitimate mental health diagnosis actually mean?
LH: A mental health diagnosis does NOT mean you’re “crazy.” The only reason diagnoses exist is to give behavioral patterns a name, so that we can best prescribe solutions. Depression, anxiety, bipolar disorder, etc. simply mean that you have the necessary number of symptoms to fit the pattern called this or that in the diagnostic manual (DSM-V). The criteria for each diagnosis vary, but the most common diagnoses share several criteria: changes in sleep patterns, marked change in appetite, significant weight loss or gain, fatigue, difficulty concentrating.
It’s very important to note that one less symptom takes you from meeting criteria to not meeting criteria. For example, if you meet four out of the nine criteria vs. five out of the nine criteria for a specified diagnosis, your behavioral pattern gets no name — no diagnosis. Think about it; getting a proper night’s rest cannot be the difference between a “crazy” person and a “normal” person, which means both concepts are bullshit. We’re all just human.
B+C: What a powerful explanation; that makes so much sense. Since mental health must be a top priority, what are some things anyone can do to improve their well-being? What do you suggest we remind ourselves about daily?
LH: First, you are the solution. The first action toward emerging and thriving — regardless of symptoms and/or diagnosis — is to make healthy lifestyle changes. You have to remember that our bodies and our brains require daily maintenance when it comes to eating, sleeping, and moving. Anyone feels terrible if their system is out of whack, which doesn’t make a person “disordered.” Remind yourself that helping your body work for you rather than against you will definitely help level the playing field, both in terms of getting you a good baseline and erasing a few symptoms. Then, it’s easier to see what’s left to tackle on the emotional front.
Not sure where to start? Here are some suggestions I regularly share:
1. Eat healthy. Eat three meals and two snacks per day. Fill half of your plate with fruits and vegetables, a quarter with grains, and a quarter with protein. Eat red meat two or more times a week; fish two or fewer times per week; fill in the rest with poultry or vegetarian protein sources like tofu and eggs.
2. Sleep consistently. Your body likes a schedule. It might not be fun to get on one, but you’re fighting for your life here! Go to sleep every night with no exceptions at 10:30pm, and get up and at ‘em at 7:30. Get your circadian rhythm working for you, rather than against you.
3. Exercise regularly. Exercise is important for everyone, but for those of us with mood concerns and/or anxiety, it’s really critical. Research suggests that a 30-minute run gives us the same boost in serotonin levels (the brain chemical that makes you feel good) that we could expect from a low dose of a selective serotonin reuptake inhibitor (SSRI) like Zoloft or Prozac.
Lifestyle patterns are tough to change, especially when you feel awful, have no energy, can’t motivate yourself, and can’t get comfortable. I know firsthand, so I never suggest anything that I don’t practice. I personally run every day to balance my mood and decrease my nervous energy. I hate every single minute of it, but I hated anxiety and low self-esteem a lot more. To feel better long-term, you’re going to have to do things that aren’t comfortable. You’re super-uncomfortable anyway, so remember that this discomfort is a means to a better end.
Did you watch 13 Reasons Why? Share your take on it with us @BritandCo!
(Photos via Netflix)