Everyone has a book that saved them. Not necessarily their life – although books have done that – but changed their perception of the world, or, less drastically, brought into focus or clarity an element of their existence. Walking through Waterstones, one cannot help but notice Reasons to Stay Alive; Shoot the Damn Dog: A Memoir of Depression; An Apple a Day; Mad Girl. Books written by celebrities or public figures, and occasionally by ordinary people whose experiences have been extraordinary. What I’m going to call the ‘mental health memoir’ is fast becoming a genre in its own right, in a society facing what experts warn is a “mental health crisis”.

To attempt a loose definition, the mental health memoir is a prose work whose central dilemma is located in a struggle – usually the protagonist’s – with a mental health problem. If they do not mimic them exactly, they are at least loosely based upon, or inspired by, the author’s experience of the same issue. They are largely conventional in terms of their narrative style, though many have a certain verbosity which would not be out of place in poetry.

If one book could define this genre, it is The Bell Jar, published in 1963 a few months before the suicide of its author, Sylvia Plath. It’s a quasi-autobiographical account of Plath’s struggle with depression and nervous breakdown, so close to the truth that it was initially published under the pseudonym of Victoria Lucas so as not to offend the real-life equivalents of some characters featured in the book.

The beauty of The Bell Jar is that it’s not a re-perspectivised self-help book. The narrator, Esther Greenwood, has a view of her mental illness which is often disarmingly cynical, wry and politically incorrect, and a version of reality which is palpably distorted by that mental illness. There is no straight progression from illness to health, and although the ending is cautiously optimistic (she’s leaving her rehabilitation clinic), the overall effect of the book is to disorientate the reader, forcing them to question the boundaries of sanity and wellness that (patriarchal) convention has bequeathed them. 

Thirty years later, the mantle was taken up by Susanna Kaysen in Girl, Interrupted, another account of a breakdown and recovery set partly in the very psychiatric hospital where Plath stayed as a patient in the 1950s. Kaysen’s book seems deliberately to set itself closer to reality than Plath’s. It describes itself as a memoir; it is less poetic than Plath’s, and attempts a more forensic examination of the other patients in her ward. But this is offset by a bizarre opening in which the narrator compares insanity to a parallel world. Again and again, the mental health memoir probably qualifies as the prose genre most likely to straddle the line between fiction and reality.

There are many reasons for this. As with Plath, fiction serves as a veil for many people writing about their own past. Then there’s the Freytag Triangle that some writers feel pressured to mimic, which leads to a distortion of the ordinary human experience, so lacking in the peaks and troughs that often feature in a good novel. The main barrier, however, must be the difficulty associated with accurately recalling and conveying subjective emotions and experiences. All of which combine to make the mental health memoir changeling and artificial, but also intense and profound. Reading The Bell Jar sometimes feels like looking at the world through those fly-eye magnifiers we used as children: the colours and shapes of the real world are still there, but it’s pixelated, stylised, and abstracted.

For anyone whose experiences remotely resembles the author’s, it is this lack of exactitude which is invaluable. We may go to a fantasy or historical novel to escape the world that we know; we open the mental health memoir to confront our experiences, rather than see them wrested from us. Where accuracy of detail would deny us access to our own memories, preventing us from projecting them onto the storyline, the fly-eye of the mental health memoir validates our experiences through incorporating them. And for as long as we can identify with unhappy protagonists, we may be able to imagine our own happy endings