On Arriving At This Novel “About” Mental Illness

Mira T. Lee

I’ve often felt awkward when asked what my book is about. I’ll say it’s a messy family drama about two sisters, how their lifelong bond is tested as the younger struggles with a mental illness. Uttered aloud, these last two words may elicit a flinch, I’ve found, as though we’ve been suddenly lifted from the realm of casual cocktail party conversation and thrust into something More Serious.

I didn’t set out to write a story about mental illness. In my earliest drafts, my protagonist, Lucia, landed in a psychiatric ward for one long chapter, but for the rest of the book, her illness miraculously disappeared. Her primary conflict then took the form of an unfulfilling marriage, where she faced the choice between staying and living with her own discontent, or leaving and hurting people she dearly loved. An astute reader, my former biology professor from grad school, said, “You have a dilemma here, yes, but it’s one we’ve seen in fiction a thousand times before. What will make yours stand out is Lucia’s illness.”

He was right. I’ve seen loved ones struggle with mental illness for decades, and I’ve experienced the chaos and discord and painful rifts it can cause. As a writer, I’d let these experiences skirt the edges of my work, but had been too afraid to embrace them fully. I worried that schizophrenia in particular carried too many negative connotations, the very word a stigma, dark and heavy. But I also knew, deep down, that allowing Lucia’s affliction to stay underdeveloped felt cowardly, like the shirking of some tacit responsibility. So I would “go there,” under one condition, I told myself—I would not let Lucia be defined by her illness. Bright, adventurous, full of ideas and dreams, she’d remain a vital, three-dimensional character: a sister, a mother, a daughter, a spouse, a modern woman trying to balance family and career. This would remain a book about her life, not her illness, as well as the lives of the people in the world who love her most. And with this in mind, I gave the illness full rein: to complicate my characters’ relationships, test their morals, expose their flaws, derail their goals. The heart of the story would emerge as they were forced to cope, each in their own imperfect ways.

In recent years, several novels dealing with mental illness have received critical acclaim: Nathan Filer’s The Shock of the Fall, Neal Shusterman’s YA triumph, Challenger Deep, Adam Haslett’s award-winning depiction of depression, Imagine Me Gone, bestselling YA author John Green’s courageous Turtles All The Way Down. It has been incredibly heartening to see people paying attention to these stories. But as I was writing my own, I worried my characters wouldn’t cut it—perhaps the combination of them, on the surface, was too odd, their lives too unlikely: the sisters are Chinese-American, the men include an Israeli shopkeeper, a Swiss urologist, an undocumented Ecuadorian immigrant; a portion of the story takes place in South America. Was my story relatable enough? I wondered if books could be about Asian-American sisters, or undocumented Latino immigrants, or cross-cultural romances, or mental illness—but not all at once.

But as I looked around, what I saw rarely in fiction I saw everywhere in life: Japanese pianists with German programmers, Greek chefs with Colombian economists, people of every race, ethnicity, and socioeconomic class, entangled. Immigrants, falling in love. This was reality, one that felt quintessentially American.

Mental illness, too, is colorblind; it strikes every community, and its ripple effects spread far and wide.


Dealing with brain illnesses differs from dealing with other physical illnesses in substantive ways. For example, with cancer or heart disease (both of which run in my family), one tries to work with doctors to decide the best course of treatment, with the shared goal of remission and recovery. With psychotic illnesses, which may involve delusions, paranoia, and/or hallucinations—the distortion of reality often renders an individual incapable of recognizing their own deficits. If a loved one’s illness has them convinced they are the Messiah, then telling them they’re sick and in need of psychiatric care is unlikely to be effective, and may even provoke intense conflict. It’s this “lack of insight” (termed anosognosia) that leads to a cruel catch-22: it is excruciatingly difficult to obtain treatment for someone with a mental illness if they refuse to acknowledge they are ill. This means that working within the mental healthcare system too, is an uphill battle, where people often must hit rock bottom (“stage 4”)—by which time they are so incoherent, incapacitated, delusional, or violent that they pose an imminent threat to themselves or others—before treatment can even be sought, much less procured.

There are no easy answers when it comes to the best way to help a loved one who is mentally ill, just as there are no miracle cures for those living with these illnesses. Families muddle through. These are issues not well explored in fiction, and that’s where the character of Miranda, Lucia’s protective sister, comes in: she’ll face a set of intractable dilemmas, and have to tackle them with what grace she can.

Over four years and six drafts, the novel evolved; what seemed arbitrary at first grew to feel integral, tentativeness and doubt gave way to conviction. Maybe I told the only story I could: big and messy, with no simple answers, no flawless heroes, no neat categories. Like life. The characters yearn, they strive, they flounder, they try again. But I have come to love every one of them. In the end, maybe that’s the best a writer can do.

Mira T. Lees work has been published in numerous quarterlies and reviews, including TriQuarterly, The Missouri Review, The Southern Review, and The Gettysburg Review, and was nominated for the Pushcart Prize. She was awarded an Artist’s Fellowship by the Massachusetts Cultural Council in 2012. She is a graduate of Stanford University, and lives with her husband and two young sons in Cambridge, Massachusetts. Everything Here is Beautiful is her debut novel.